Volvulus in pregnancy: a diagnostic dilemma

In this case report, we describe a pregnant female patient at 27 weeks' gestation with a rare complication of volvulus. Her initial symptom was acute cramping pain of the lower right abdomen. Surgical intervention was performed under the impression of peritonitis. Pathologic diagnosis revealed volvulus of the mid ileum. The remainder of her pregnancy was uneventful. The physiologic changes of pregnancy may predispose the parturient to bowel obstruction due to compression of the gravid uterus against the intestine. If volvulus is suspected, then emergent surgery should be performed. Delays in treatment may result in septic shock and even death. We present this case to remind obstetricians of such rare causes of acute abdomen during pregnancy.